OKOJ, Volume 5, No. 9

Rupture of the distal biceps brachii tendon is uncommon, accounting for less than 5% of biceps tendon ruptures. The injury typically occurs in middle-aged men as a result of the application of a sudden extension force on a concentrically flexed biceps. Most often, the tendon avulses from its insertion on the radial tuberosity. In this video, Dr. Wolfe performs reattachment of the distal biceps tendon to its radial insertion using a 9-mm Endobutton (Smith&Nephew, Memphis, TN). This procedure allows for a relatively minimal, single anterior incision to reattach the tendon. Additionally, the tendon is secured within the medullary canal of the radius, which enhances the healing potential of the repair. The procedure also provides for extremely secure fixation of the tendon, allowing the patient to have good range of motion and active flexion and supination soon after surgery and, therefore, earlier return to work and activities of daily living. Dr. Wolfe demonstrates his surgical approach and shows how to prepare the ruptured tendon end and attach the Endobutton, drill the cortex of the radius for passage of the tendon, and perform closure of the wound.

Pathology of the proximal biceps tendon describes tendon instability, tearing, inflammation, and/or chronic degeneration, all of which can cause significant shoulder pain and dysfunction. In older, less active patients, conservative treatment is routinely chosen because it results in little functional loss and a mild cosmetic deformity. However, in the young active patient, a biceps tenodesis should be performed. Numerous biceps tenodesis techniques have been described in the literature. This article describes three of the most commonly used procedures: arthroscopic tenodesis to bone, arthroscopic fixation to soft tissue, and an open subpectoral approach to fixation. Typically, surgeon preference and comfort with the procedure dictate which technique is ultimately chosen. Excellent early results have been reported for all three methods.

Keywords:

bicipital tendinitis

biceps tendinitis

attrition tendinitis of the biceps

biceps tendinosis

bicipital tenosynovitis

biceps tendon pathology

biceps rupture

biceps tear

arthroscopic biceps tenodesis

subpectoral approach

Subspecialty:

Sports Medicine

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